What Is Peritonitis?

Peritonitis is a bacterial or fungal infection of the peritoneum, the thin, silk-like membrane that lines your inner abdominal wall.

The peritoneum protects the organs within your abdomen, such as your liver, stomach, and intestines.

Peritonitis results in pain, inflammation, and irritation, and requires immediate medical attention to treat the infection and any underlying condition that may have caused it.

Causes of Peritonitis

Peritonitis is caused by a collection of blood, body fluids, or pus in the abdomen. There are two types of peritonitis:

Spontaneous peritonitis is most often caused by an infection in fluid that collects inside the abdomen.

The fluid buildup tends to occur with advanced liver or kidney disease, and in people who are on peritoneal dialysis for kidney failure. It can also be due to inflammation, infection, or injury of the intestines.

Secondary peritonitis occurs due to another condition in the body, such as an infection that spreads from the digestive tract caused by a ruptured appendix, a stomach ulcer, diverticulitis, or a perforated colon, for instance.

Injuries like gunshot or knife wounds can also bring about the infection, as well as the use of dialysis catheters or feeding tubes.

Peritonitis caused by bacteria can also develop into sepsis, which is a very serious infection of the bloodstream.

Premature babies who have underdeveloped organs (necrotizing enterocolitis) may also be susceptible to secondary peritonitis.

Complications of Peritonitis

Hepatic encephalopathy, the loss of brain function caused by the liver’s inability to remove toxins from the blood

Hepatorenal syndrome, which occurs when there’s progressive kidney failure in people with cirrhosis of the liver

Death

Diagnosis of Peritonitis

If you’re on peritoneal dialysis, your doctor may be able to diagnose peritonitis simply by your signs and symptoms, particularly if you are experiencing cloudy dialysis fluid.

If your doctor needs further confirmation or if the infection may be a result of other medical conditions, your doctor will most likely perform a physical exam of your abdomen to feel if it is unusually tender or firm.

Your healthcare provider may also conduct one or more of these tests:

Peritoneal fluid analysis is done by using a thin needle to take a sample of the fluid in your peritoneum. An elevated white blood cell count in the fluid may indicate an infection or inflammation, and a culture of the fluid may also indicate if bacteria are present.

Blood tests can also reveal if you have a high white blood cell count, and a blood culture can determine if there are bacteria in your blood.

Imaging tests, such as an X-ray, ultrasound, or computerized tomography (CT) scan can check for fluid, gas, masses, or abscesses in your abdomen. or other perforations in your gastrointestinal tract.

Treatments of Peritonitis

Once the cause of peritonitis is identified, treatment should begin immediately. If left untreated, peritonitis can lead to severe, life-threatening conditions.

Treatment may include antibiotics to help fight the infection and keep it from spreading.

Surgery may be used to remove infected tissue, treat the underlying cause of the infection, and prevent the infection from spreading.

Other treatments, such as pain medications, intravenous (IV) fluids, supplemental oxygen, and a blood transfusion may be used if you are hospitalized for peritonitis.

If you are on peritoneal dialysis, you may need to receive dialysis in another way until your body heals from the infection.

If peritonitis persists or recurs, you may need to permanently switch to a different form of dialysis.

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